Response to Better for Some, Maybe Not for All: A Response to Preemptive Transfusion and Infusion Strategy in Children during Craniofacial Reconstruction

Paolo Cortellazzi (1) , Dario Caldiroli (1) , Massimo Lamperti (2) , Monica Bricchi (1) , Laura Valentini (3)

1 Neuroanesthesia
2 Neuroanesthesia
3 Neurosurgery

The authors reply with more details about the results of their study.Median intra-operative blood losses of Control group were 20% of estimated red cell volume (95% CI: 4%-73%) while perioperatory blood losses were 50% (95% CI: 25%-120%). Most infants of this series showed post-operative hematocrit values lower than 20% and , given their unstable clinical conditions, the clinicians transfused blood products in 22 of them. During the post-operative period and at discharge from the hospital, hematocrit was never lower than 20%. In this group, the outcome measures considered in our study (i.e. feeding time lower than seven hours to the end of surgery, length of stay in the intensive care unit and post-operative length of stay in hospital) were considerably better.Without doubt, less invasive surgical techniques (2-4) in comparison to the traditional procedure adopted by our team (2) are crucial to reduce perioperatory blood loss. Beyond this,there is still a lack of evidence on the final results for all craniosynostoses treatment, in terms of cephalic index and 3D-head CT scan between CVR, spring-mediated cranioplasty and endoscopic strip craniotomy.

Mots clés: Medicine

Paolo Cortellazzi, Dario Caldiroli, Massimo Lamperti, Monica Bricchi, Laura Valentini. Response to Better for Some, Maybe Not for All: A Response to Preemptive Transfusion and Infusion Strategy in Children during Craniofacial Reconstruction. Pediatric Anesthesia, 2010, 20 (7), pp.675. ⟨10.1111/j.1460-9592.2010.03321.x⟩. ⟨hal-00552643⟩